Individual
DR. MATTHEW OLEN THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-1018
(336) 716-2255
Mailing address
87 HULME CT APT 716, STANFORD, CA 94305-7428
(650) 223-1093
Taxonomy
Speciality
Code
Description
License number
State
2085P0229X
Pediatric Radiology Physician
Primary
2018-01571
NC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
12/22/2013
Last updated
07/15/2019
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